No matter in Hong Kong or overseas countries, there are many enthusiasts eager on bus hobby and even on preserving old buses. It is noted that double-decker buses could sometimes mean more than a vehicle, they could be an icon or pride for a community, for example, the red bus is the icon of London. In UK, there are many bus or transport museums in preserving the old buses. The overseas practice has triggered local expectation on similar preservation practice for Hong Kong’s double-decker buses. A transport museum in Hong Kong has been advocated in recent years; however, the idea is still immature. In-depth discussion and study of this topic is also absent at this moment. The objective of this dissertation is to fill-up this gap. Not many places in the world have long history of extensive & continuous use of double-decker bus (e.g. UK’s main cities, Dublin, HK, Singapore, and Berlin). This rarity justifies that more attention should be paid on Hong Kong old double-decker buses. The extensive use of 3-axle double-deckers is also a local characteristic. Double-decker buses have been existing in Hong Kong since 1949. The extensive use of double-decker buses in Hong Kong is closely related to the social and economy development of the community. There is potential for double-decker buses to be treated as a cultural heritage asset for Hong Kong, and as a representative for Hong Kong. The cultural heritage about double-decker buses has not been well recognized in the local community. Many old double-decker buses disappeared without any attention paid. Preservation of old double-decker is occasionally undertaken by the bus operators or individual bus enthusiasts. In this research, the overseas practice for preservation of old buses, especially the British cases, will be reviewed. Comparison of the British and Hong Kong double-deckers history will also be undertaken. Finally, the discussion on whether and how Hong Kong should preserve our own buses will be made. / published_or_final_version / Conservation / Master / Master of Science in Conservation

Objectives Medication adherence is one of the most important aspects of the treatment plan for successful recovery of patients with psychosis. Medication non-adherence leads to increased relapse rate, risk of violence, symptom severity, hospitalization, and suicide risk; reduced mental function and life satisfaction; as well as increased economic burden to society. The aim of this study was to examine the predictors of medication adherence for first-episode psychosis patients in a three-year retrospective cohort study. Methods The retrospective cohort study evaluated the potential predictors of medication adherence over 3 years in first-episode psychosis patients. Patients having a good adherence rating (1 or 2 on a 4-point scale) for 8 months or more were categorized into the good adherence group for that year. Patients having a poor adherence rating (3 or 4 on a 4-point scale) for 5 months or more were categorized into the poor adherence group for that year. Potential predictors for medication adherence were gender, age, years of education, migration, occupation impairment, premorbid functioning, duration of untreated psychosis, mode of onset, diagnosis, hospitalization at first presentation, positive, negative and depressive symptoms at 1 month, stressful life experiences, and early intervention. The dependent variable was medication adherence by the patient. Binary logistic regression analyses were performed to explore predictors for non-adherence at 1, 2 and 3 years. Results Among the 1400 patients recruited into the study, non-adherence rates were 15.7% (190/1208) at year 1, 15.3% (171/1115) at year 2, and 12.1% (125/1029) at year 3. From the logistic regression analyses, suicide attempt at baseline (p=0.027, OR=2.233) and mode of onset (p=0.035, OR=1.583) were found to be predictors of poor medication adherence at 3 years following the first episode. Common significant predictors were identified at year 1 and year 2. Standard care (p=0.000, OR=2.332), hospitalization at baseline (p=0.001, OR=2.095), stressful life event (p=0.015, OR=1.567), migration status (p=0.048, OR=1.472), more years of education (p=0.024, OR=1.084), lower positive symptom severity (p=0.001, OR=1.372) and paranoid schizophrenia (p=0.043, OR=1.444) were found to be predictors of poor medication adherence in the two years following the first episode. Conclusions It is clear from our study that early intervention comprising an individualized care plan enhanced medication adherence, but these benefits lasted only until the treatment ended. It is recommended that the early intervention service should be extended to 5 years and include patient-centred interventions for high-risk patients: an adjustment and adaptation programme for immigrants (specifically new immigrants to Hong Kong); a stigma reduction programme for teenagers; psychotherapy, group therapy and individual counseling for patients who have experienced stressful life events or attempted suicide; and sustained education on medication adherence for acute and sub-acute onset patients. These strategies of intervention tailored to the individual could be introduced to improve medication adherence in psychosis patients. Further studies on medication predictors including insight level, side effects of medication, social support level, level of premorbid intelligence and therapeutic relationships, could identify potential predictors of medication adherence, which can be targeted to reduce relapse, decrease hospitalization and reduce the cost to society. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Hospitalization was one of the most important variables to study in patients of first-episode psychosis. Many literatures had done in the past to predict hospitalization in western countries, yet, little was done in Asian countries. In this study, the author aimed to examine the variables associated with hospitalization in seven hundred Chinese young people presented with first-episode psychosis to a specialized early intervention service in Hong Kong; the variables for examinations were mainly consisted of baseline characteristics and clinical variables such as socio-demographics, duration of untreated psychosis (DUP), age of onset, mode of onset, types of diagnosis and past history of suicide attempt. In comparison with patients who were admitted in the 3-year period EASY service, those who were never admitted during the service period were more likely to have higher educational attainment, older age at entry of the service, had insidious onset, longer DUP, unlikely to have suicide attempt history and were diagnosed with non-schizophrenia spectrum disorder. When comparing patients who were only admitted once during those three years with patients who were admitted more than once, patients admitted only once were more likely to be older age at entry of the service, have longer DUP and unlikely to have suicide attempt history. Regarding the 3-year outcome comparison between patients who were admitted voluntarily and compulsorily in the first month of the EASY program, voluntarily admitted patients were found to have more affective symptoms and shorter duration of initial admission; they were also found to have shorter duration of total hospitalization even after controlling patient’s age at onset, age at entry and length of initial admission. Results from the current study can shed some light on the predictors of hospitalization of first-episode psychosis patients in Hong Kong. Further researches are needed in order to have a more comprehensive picture regarding hospitalization. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Objectives: Public stigma has been identified as a major obstacle for the recovery process of persons suffering from psychosis. Psycho-education to the public is suggested to be effective in enhancing public knowledge and understanding of patients with psychosis. It claims to be an effective way to reduce discrimination against and the labelling effect on mentally ill patients. However, there is a lack of understanding on the relationship between knowledge and attitudes. The current study aims at evaluating the relationship between public knowledge and public attitudes on persons with psychosis; and at identifying how violence factor influences the public attitudes. The implications of the findings for planning a psycho-education programme are discussed. Method: Subjects (n=81) were recruited from public health talks on psychosis organized by the Jockey Club Early Psychosis Project (JECP). General knowledge about psychosis was assessed with a modified multiple-choice questionnaire, Knowledge about Schizophrenia Test (KAST). Two hypothetical descriptions of two patients with psychosis were designed, with one of the descriptions associated with violent behaviour and the other without. Subjects rated their willingness to interact with the hypothetical patients using a 19-item social distance scale. Other assessments included subjects’ previous contact with patients of psychosis and their history of working in the medical field. Results: The overall level of knowledge about psychosis of subjects was good. Subjects at an older age were associated with better knowledge of psychosis. No correlation was found between overall knowledge and attitudes. However, subjects having better knowledge in Cause of KAST were correlated with less rejecting attitudes towards patients of psychosis. The current study has identified that violence is a significant factor that influences the attitudes of subjects. Significant rejecting attitudes were found in violence vignette as compared to non-violence vignette. Female subjects were found having significantly higher rejecting attitudes towards patients of psychosis with violent behaivour. Previous contact with patients and history of working in the medical field found no correlation with attitudes in this study. Conclusion: The current study suggests that violence factor has a significant correlation with attitudes towards patients of psychosis. The rejecting attitudes influenced by the impression of violent behaviour of patients with psychosis are likely difficult to be removed. The labelling and stigmatizing effect on patients with psychosis through sensational description of violence by mass media is considered influential. Mass media should acknowledge their crucial role by stopping news reports using sensational, dramatic descriptions on violent incidences of mentally ill patients. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background Non-adherence at psychiatric out-patients clinics has serious impact on clinical and economic outcomes. It is costly to both health care systems and the patients. This study aimed to examine the predictors of treatment adherence in a group of patients with first episode psychosis in Hong Kong. Methods Thirty five patients with psychosis underwent assessment for prospective memory, insight and social support at baseline. Clinical symptoms were also measured. Linear regression was used to identify predictors of treatment adherence at baseline. Actual medication adherence was assessed three months later and multiple linear regression models were used to identify predictors of non-adherence. Results The effects of independent variables age, gender, number of psychiatric hospitalization, and prospective memory were no statistically significant to treatment adherence. But educational level, insight and social support were showed positive correlation with treatment adherence. Conclusions The study demonstrates that treatment adherence is associated with level of education, insight and social support system. These factors are important to assess when trying to estimate the degree of medication adherence and its relationship to clinical presentation. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

The primary focus of this dissertation is to examine how graffiti is emplaced in Hong Kong. Artifactual and contextual photographs have been collected of examples of graffiti and will be considered according to their place in the semiotic aggregate, the facets and foci of thirteen styles of graffiti, and as they represent the inscription site. Geosemiotics, defined as ‘signs in place’, will be utilized to analyze the transgressive nature of graffiti. Gestural routines are also studied as they relate to the body of the graffiti writer acting in space, inscribing place. The subsets of graffiti as it relates to urban and street art is weighed as well as the tools and means at its disposal. An understanding of Hong Kong’s situated cultural experience in negotiating meaning and contesting perception through inhabiting public space made cultural space will be sought in this dissertation. The way in which previous cultural understandings of rock-carving and inscription, as well as a study of the terms as used in Hong Kong can help to illuminate the background of graffiti as it has occurred within Hong Kong and China. Finally, a purposeful look at the active sight of the individual in coming to terms with the language systems in urban spaces can give a nuanced perception of how the material placement of graffiti challenges planned space and provides a ‘street-wise’ aesthetic. / published_or_final_version / English Studies / Master / Master of Arts

This field guide has been carried out to fulfil part of the requirements of my master’s degree in the field of Applied Geosciences at the University of Hong Kong. The project was mainly written from September 2012 to July 2013 under the supervision of Dr. Jason R. Ali. The objective of the study was to produce a simple, easily understood, geological guide of areas on eastern and central Lantau Island. The guide intends to introduce useful, fundamental concepts of geomorphology and geology to everyone who visits the selected study areas. Data has been obtained by a literature survey, interpretation of aerial photographs, use of geological and topographic maps and much fieldwork. The information is presented in the form of a simple field guide divided into four chapters. Chapter 1 is the introduction, while Chapter 2 presents background information of the geology of Lantau Island and Chapter 3 is the actual field guide divided into two areas, east Lantau and central Lantau. Chapter 4 concludes this dissertation. It is concluded that Lantau Island exhibits many interesting landscapes and geological features. This field guide provides convenient and easy to understand information for any person, professional or amateur, having an interest in understanding their surroundings (the physical environment) when visiting Lantau Island. / published_or_final_version / Applied Geosciences / Master / Master of Science

Ineffective and tough parenting has been associated with physical child abuse. Parenting support would be the key component to act as a preventive measure of the problem. The evidenced based parenting intervention has proved to reduce prevalence of child abuse and children behavioural and emotional problems as well. As a result, there is a marked increased international recognition of the value of Positive Parenting Program (Triple P). Triple P is developed at University of Queensland in Australia. It is based on social learning models and proved that is effective, especially on managing early onset of children’s conduct problems by enhancing parental competence. Group Triple P is an intensive level (level 4) of Triple P. It is identified as universal parenting support program. Department of Health of Hong Kong has launched Triple P in 2002. Research was carried out to prove that it was an effective parental intervention on reducing the parental stress and enhancing the martial relationship in HK. The course is delivered by nurses only, named as accredited facilitators. However both incidence rate of child abuse and nurses’ workload are increasing dramatically in recent years. Better distributing the resources should be addressed immediately. In order to enhance the efficiency of the course with limited resources, a new protocol to improving by synthesis of the high level evidenced studies should be proposed. According to the studies’ results, the program design of Group Triple P could be modify into four group sessions instead of eight by cancellation of four telephone sessions. Thus more parents would access to the course as shortening their waiting time with better utilisation of nurses’ manpower. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Psychological distress aroused by stigma may lead to impairments in attentional functioning because it calls attention to the experience of stigma-related stress. Very few studies have actually considered whether stigma could disrupt attentional functioning by serving as distractors with emotional valence in the schizophrenia spectrum, given that there is a possible dysfunctional affective system in response to processing of emotional information. This research employed the paradigm of emotional Stroop task and attentional probe task to investigate how stigma impacts on the functioning of selective attention. The primary objective of this current study was to investigate how selective attention, as measured in terms of reaction time and accuracy, can be disturbed by stigma-related stimuli in schizophrenia patients. The secondary objective of this study was to test the assumption that schizophrenic patients with higher sensitivity towards stigmatization will demonstrate higher impairment of selective attention in relation to stigma-related stimuli, since they may display more intense negative emotions than patients with lower sensitivity. For emotional Stroop task, two categories of stimuli, including stigma-related words (emotional arousing to schizophrenic patients), furniture-related words (neutral stimuli) were shown in different colors and the subjects were instructed to name the color of words as fast and as accurate as possible. For attentional probe task, a stigma-related word was paired up with a furniture-related word in each trial. Participants had to respond as soon as they detect the dot in the position previously occupied by the words. Two groups of participants, healthy controls (N = 40) and patients with schizophrenia-related disorders (N = 40) were compared regarding their performances on emotional Stroop task and attentional probe task. The patients were further split into two groups; high-sensitivity towards stigma (N = 19) and low-sensitivity towards stigma(N = 18),for comparison on various variables, like level of symptoms, depression, medical adherence and awareness of mental disorders. Based on the group comparison of performance on emotional Stoop task, schizophrenic patients exhibited significant emotional interference with the presentations of stigma-related words when compared with the healthy controls. Although the group comparison of performance on attentional probe task did not provide a significant result, schizophrenic subjects obtained higher difference scores which indicated that they were in general displayed more attentional bias towards stigma-related stimuli as compared to furniture-related stimuli. Both emotional Stroop and attentional probe task results show that schizophrenia patients in high-sensitivity subgroup demonstrated the greatest effect of emotional interference with the presentations of stigma-related words. Level of emotional interference for stigma-related stimuli in schizophrenic patients was moderately correlated with the measure of positive symptoms severity, and patients in high-sensitivity group had a significantly higher mean depressive symptoms score than patients in low-sensitivity group. Such information might help to identify potential risk factors and lead to improved treatment and prevention strategies for psychotic patients. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Human coronaviruses were first discovered in 1960s and believed to be the causative agents of only mild respiratory tract infections. In 2003, the worldwide outbreak of Severe Acute Respiratory Syndrome caused by SARS-CoV had greatly boosted the research interest on coronaviruses. Two more human coronaviruses – HCoV-NL63 and HCoV-HKU1 were then discovered in 2004 and 2005 respectively. Events of recombination between different genotypes had also been detected in HCoV-OC43 and HCoV-HKU1 in natural circulating strains that are causing infections. Creation of novel genotypes is resulted, which may possibly associate with more severe disease. In this study, twenty seven HCoV-NL63 strains in Hong Kong from 2004 to 2012 were included in the investigation. RNA-Dependent RNA Polymerase gene, Spike gene and the Nucleocapsid gene of these strains were sequenced, followed by phylogenetic analysis and bootscan analysis. Antigenic drift from genotype A (in 2004-2006) to B (in 2003-2010) and C (in 2009-2012) were observed. Two local strains clustered with an American strain in all three genes, which the American strain had been formed by recombination between genotype A and C. Five recent strains from 2009 to 2012, along with two Beijing strains, may belong to a potential novel genotype. Two more strains were discovered with atypical genomic profile. Complete genome sequencing would be the further work for clear investigation on their sites of recombination. No clear association between the genotypes and clinical features had been observed. / published_or_final_version / Microbiology / Master / Master of Medical Sciences